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Endoscopic retrograde cholangiopancreatography-related early perforations:A study of effects of procedure duration,complexity,and endoscopist experience

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World Journal of Gastrointestinal Endoscopy 2023年第11期15卷 641-648页

作者： Mark Aloysius Hemant Goyal Tejas Nikumbh Niraj James Shah Ghassan M Hammoud Pritesh Mutha Mairin Joseph-Talreja Savio John Ganesh Aswath Vaibhav Wadhwa Nirav Thosani Division of Gastroenterology Department of Internal MedicineSUNY Upstate Medical UniversitySyracuseNY13210United States Department of Surgery The University of Texas Health Science CenterHoustonTX 77030United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18510United States Department of Medicine Division of Digestive DiseasesThe University of Missouri at ColumbiaColumbiaMO 65211United States Division of Gastroenterology Department of Internal MedicineSUNY Upstate Medical UniversitySyracuseNY 13210United States

BACKGROUND perforations(Perf)during endoscopic retrograde cholangiopancreatography(ERCP)are rare(<1%)but potentially fatal events(up to 20%mortality).Given its rarity,most data is through case series studies from cent... 详细信息

BACKGROUND perforations(Perf)during endoscopic retrograde cholangiopancreatography(ERCP)are rare(perforations(NoPerf)using the Mann-Whitney U test as the data demonstrated significant skewness and kurtosis.RESULTS A total of 14153 ERCPs were performed by 258 endoscopists,with 20 reported Perf(0.14%)among 16 endoscopists.Mean patient age in years 61.6±14.8 vs 58.1±18.8(Perf vs.NoPerf,P=NS).The cannulation rate was 100%and 91.5%for Perf and NoPerf groups,respectively.13/20(65%)of endoscopists were high-volume performers in the 4th quartile,and 11/20(55%)of Perf occurred in centers with the highest volumes(4th quartile).Total procedure duration in minutes was 60.1±29.9 vs 40.33±23.5(Perf vs NoPerf,P<0.001).Fluoroscopy duration in minutes was 3.3±2.3 vs 3.3±2.6(Perf vs NoPerf P=NS).50%of the procedures were complex and greater than grade 1 difficulty.3/20(15%)patients had prior biliary surgery.13/20(65%)had sphincterotomies performed with stent insertion.Peritonitis occurred in only 1/20(0.5%).CONCLUSION Overall adverse events as a composite during ERC

关键词： Endoscopic retrograde cholangiopancreatography Endoscopy complications perforations

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Thermal performance of solar air collector with slit-like perforations

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Journal of Central South University 2009年第S1期16卷 145-149页

作者：李宪莉由世俊张欢尤占平 School of Environment Science and Technology Tianjin University

To offer a potentially low-cost and high-efficiency option for once-through applications,the unglazed transpired solar collector was studied. The semi-empirical correlation of overall heat exchange effectivenessε for UTC with circular holes was proposed to verify whether it being fit for this kind of absorber with slit-like perforations. The results show that in certain parameters,the predicted values of ε are very close to measured values,and the root mean square difference in betweens about 0.10,so the modle is suitable. Based on experimental results,this kind of absorber is proved to be feasible,with highest value of ε,up to 0.81. In addition,with the increase of γ,overall heat exchange effectiveness ε will decrease,i.e.,the value of ε will decrease with the increase of suction velocity vs or the decrease of wind velocity uw. However,the actual value of solar radiation intensity G and ambient temperature T∞ have little influence on ε.

关键词： unglazed transpired solar collector overall heat exchange effectiveness slit-like perforations

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New devices and techniques for endoscopic closure of gastrointestinal perforations

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World Journal of Gastroenterology 2016年第33期22卷 7453-7462页

作者： Yue Li Jian-Hua Wu Yan Meng Qiang Zhang Wei Gong Si-De Liu Department of Gastroenterology Guangdong Provincial Key Laboratory of GastroenterologyNanfang HospitalSouthern Medical University

Gastrointestinal perforations,which need to be managed quickly,are associated with high morbidity and mortality. Treatments used to close these perforations range from surgery to endoscopic therapy. Nowadays,with the development of new devices and techniques,endoscopic therapy is becoming more popular. However,there are different indications and clinical efficacies between different methods,because of the diverse properties of endoscopic devices and techniques. Successful management also depends on other factors,such as the precise location of the perforation,its size and the length of time between the occurrence and diagnosis. In this study,we performed a comprehensive review of various devices and intro-duced the different techniques that are considered effective to treat gastrointestinal perforations. In addition,we focused on the different methods used to achieve successful closure,based on the literature and our clinical experiences.

关键词： Gastrointestinal perforations Devices Techniques Endoscopic closure Treatment

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Experimental, Mathematical and Finite Element Analysis (FEA) of Temperature Distribution through Rectangular Fin with Circular perforations

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Modeling and Numerical Simulation of Material Science 2017年第2期7卷 19-32页

作者： Joel Hemanth H. M. S. Institute of Technology Tumkur India

Fins are the extended surfaces through which heat transfer takes place to keep the surface cool. Fins of various configurations are presently used ranging from automobile engine cooling to cooling of computer parts. Note that in a fin majority of the heat transfer to atmosphere is by convection and therefore in the present research, and importance is given to variation of temperature along the length of the fin which in turn gives rate of heat transfer. In the present research a solid rectangular aluminum fin and the same rectangular fin with different perforations (2, 4, 8 and 10) were compared analytically, experimentally and its validity through finite element analysis for its temperature distribution along the length. From the present research it is observed that the mathematical and FEA for a solid rectangular fin without perforations are converging within ±1°C and rectangular fin with 10 perforations are converging within ±2°C and hence the validity.

关键词： Fin Mathematical Temperature FEA and perforations

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四分之一圆非越浪型穿孔防波堤稳定性研究中的多元非线性回归分析

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Journal of Marine Science and Application 2020年第2期19卷 293-300页

作者： S.Binumol Subba Rao Arkal Vittal Hegde Department of Civil Engineering Shinas College of TechnologySultanate of Oman&formerly Research ScholarDepartment of Applied Mechanics&HydraulicsNational Institute of Technology KarnatakaSurathkalMangaloreIndia Department of Applied Mechanics&Hydraulics National Institute of Technology KarnatakaSurathkalMangaloreIndia

Breakwaters have been built throughout the centuries for the coastal protection and the port development,but changes occurred in their layout and criteria used for the design.Quarter circle breakwater(QBW)is a new type evolved having advantages of both caisson type and perforated type breakwaters.The present study extracts the effect of change in the percentage of perforations on the stable conditions of seaside perforated QBW by using various physical models.The results were graphically analyzed using dimensionless parameters and it was concluded that there is a reduction in dimensionless stability parameter with an increase in steepness of the wave and change in water depth to the height of breakwater structure.Multiple non–linear regression analysis was done and the equation for the best fit curve with a higher regression coefficient was obtained by using Excel statistical software—XLSTAT.

关键词： Breakwater perforations Regression analysis Stability Wave steepness Water depth

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A Comparative Study of Closure of Tympanic Membrane Perforation between Chemical Cauterization and Fat Plug Myringoplasty

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第6期2卷 248-252页

作者： Manabendra Debnath Swagata Khanna Department of ENT Gauhati Medical College & Hospital Guwahati India

The purpose of closure of small dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Small and cost effective procedures like Chemical Cauterization and Fat Plug Myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement. A study was carried out in 69 patients with central perforations in the Department of ENT, Gauhati Medical College & Hospital for the duration of 1 year from August 11 to July 12. Out of 69 patients, 36 underwent Chemical Cauterization and 33 Fat Plug Myringoplasty. Pre-and post-operative hearing assessments of each patient were done and statistically analyzed. The success rate was found to be 83.33% and 90.9% respectively. In both groups, there was statistically significant hearing improvement with a P value 0.01. From our study, it was found that the two procedures are simple, reliable and also lessened the morbidity of the patient. Thus we recommend the use of these two official procedures for the treatment of central perforations of tympanic membrane less than 5 mm.

关键词： Fat Plug Myringoplasty Chemical Cauterization Paper Patching Central perforations

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Visual Diagnosis: A Young Woman with Acute Abdominal Pain

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Open Journal of Emergency Medicine 2017年第1期5卷 8-12页

作者： Talib Dosani Lars Beattie Matthew F. Ryan Department of Medicine University of Florida Gainesville FL USA Department of Emergency Medicine University of Florida Gainesville FL USA

A 27-year-old female with a history of Crohn’s disease and familial adenomatous polyposis (FAP) presented to the emergency department (ED) with severe abdominal pain after an endoscopic exam. Chest and abdominal radiographs revealed massive pneumoperitoneum and the patient underwent emergent exploratory surgery. Herein, we discuss the management and outcomes of this case. The importance of a thorough history and physical exam when evaluating for an acute abdomen and thus the development of a successful management plan is also underscored.

关键词： Iatrogenic perforations Pneumoperitoneum Endoscopic Procedure Emergent Surgery

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